The social engine behind weight stigmas: About the reality of our food choices

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The meaning of food

Food is undeniably much more than mere nutrition, it’s a social vehicle that allows us to distinguish ourselves by lifestyle and to establish social connections. We eat to celebrate, to pay respect to the deceased, to reduce stress, to enhance our well-being, to please our God, etc. Food has endless moral significance along with numerous religious meanings (Rozin, 2005). The social habit of eating is deeply embedded (Higgs & Ruddock, 2020). Indeed, eating alone is commonly perceived as embarrassment and leading to pity looks in most cultures.

On the personal level, food is also a central of identity, incorporated into our self-definition (Fischler, 1988) that carries a lot of symbolic personal meaning. Adding these to the social meanings, results in eating being one of the most vicious fields of debate. People commonly hold strong opinions on what should be eaten, in what amount, and in what order. Some also pick their friends based on matching eating habits and are prejudiced against different food choices (Steim & Nemeroff, 1995).

Unsurprisingly, eating has extreme amount of stigma around it, and amongst the most stigmatised groups in Western cultures are the overeaters and the undereaters. Their public perception is worse than those with mental illness (Roehrig & McLean, 2010). Stigmas are known to derive from the general pressure of conformity and the consequent fear of differing from the expectation, projected to someone else. They commonly related to some moral, symbolic associations (Rasmussen, 2012), as we’ll discuss below, both overeating and undereating are associated with several, otherwise unrelated, moral traits.

Stigmatised as weak: Overeating

Overweight individuals are often portrayed in mass media as lazy, weak willed, and self-indulgent (Puhl & Heuer, 2009), fuelling moral assumptions about an overweight person. This stigma is particularly detrimental as it makes people withdraw themselves from social events in fear of ridicule which brings additional issues, such as isolation and spiralling health problems (Tomiyama, 2014). The overweight stigma often taints leisure and hobby sport events as well, where attendees reported being openly scored down for their body fat, despite their positive contribution.

Overeating has been attributed to a number of factors, including external and internal causes (Hill, 1998), the most impactful ones being discussed below.

Food variety and quality

In the contemporary developed world, there is a surplus of food that is easily accessible and comes in an enormous variety, which itself promotes eating. In addition, food technology has developed “super” foods, such as chocolate, cakes, cookies, and other palatable foods that are much more appealing, and more calorically dense than almost any food in nature (Rozin, 2005).

Psychological factors

A commonly discussed psychological factor of food consumption is the inaccurate bar for what is considered average weight. Misestimating what is the average weight is common in case of children and adolescents whose social networks (parents and schoolmates) includes a lot of overweight individuals. As a result, these kids are more likely to underestimate their own weight and develop an inaccurate picture of what is average for their age. This picture is further reinforced by their peer group as they tend to affiliate with other overweight peers due to the often experienced social exclusion (Salvy et al., 2012).

Emotional factors

The emotional factors of eating are well researched. Latest findings suggest that as a reaction to light and moderate stress, most of us eat an average 30-50% more. While when the stress reaches a severe or traumatic level, our appetites decline and we eat less (Blair et al., 1991).

There are also neurobiological components linked to overeating, suggesting that just like drugs, palatable food can activate the brain’s reward system (Blumenthal & Gold, 2010). Emotional eating bears the risk of spiralling into an overeating lifestyle via producing powerful behavioural reinforcement for eating. Repeated stimulation of the reward pathways through highly palatable food may lead to neurobiological adaptations that eventually increase the compulsive nature of overeating (Adam & Epel, 2007).

Biological factors

A well-known biological factor that impacts consumption habits is someone’s tendency to deposit fat, and other inheritable genetical predispositions (Loos & Yeo, 2022). However, a lesser known metabolic process that impacts how we process the food we eat is that fat-rich foods fails to signal the brain about fullness, leading to a form of unintentional overeating. This effect is linked to both the high energy density and the strong sensory qualities of fat-rich food (Blundell & MacDiarmid, 1997). Also, ingested fat can stimulate further food intake, which means that a single high-fat snack commonly leads to a significant increase in the amount eaten that day. These effects offer explanation to the relationship of the eating pattern that provides long-term overeating on a high-fat (low-food quotient) diet (Lissner et al., 1987).

Cultural pressure

Most of us like the idea that what we eat is our choice, but the fact is that palatable foods are actively promoted and are a major part of modern culture. Their ubiquitous nature and the constant media pressure to buy them (Zimmerman & Shimoga, 2014), accompanied with their metabolic specifics detailed above, leads to many people being unable to maintain an energy intake that does not exceed energy expenditure, resulting in an inevitable gain in weight (Blundell & MacDiarmid, 1997). The dominant narrative on overeating, which is explained exclusively via personal moral and lifestyle factors, ignores all other critical components that lead to overeating.

The cultural paradox is that, as existing research overwhelmingly demonstrates, obesity stigma results in weight gain via the added life stress (Tomiyama, 2014).

The prejudice is ever-present in every community; there is not a colleague without a ‘helpful’ dietary advice, there is not a stranger without judgment in their eyes or a ‘fat joke’ on their tongue. Today, life with extra body fat is emotionally crippling. The increased media exposure, and catastrophising terms like ‘obesity epidemic’ and ‘public health crisis’, that were originally propagated to encourage people to lose weight (Callahan, 2013), have dramatically backfired. The social exclusion, ‘fat shaming’, personal devaluation, etc. just like any other form of abuse, resulted in depressed people with less eating control, (Seacat & Mickelson, 2009), and consequently, unhealthier diets and further weight gain (Puhl and Brownell, 2006).

Stigmatized as vain: Undereating

The other target of social prejudice around eating are those who undereat. The public often trivialize their issue as just trying to look like a celebrity, belittling the challenges associated with their condition (Dimitropoulos et al, 2016). In some cases, even the first line of help, the mental health worker, labels them as ‘just too sensitive to fashion’. Even though undereating can indeed be linked to the distorted body image promoted in the media (Puhl & Suh, 2015) via the fear of social exclusion for being fat, leading to the overcontrol of weight, that is just one component.

When the overcontrol of weight meets unstable family bonds and life uncertainty (Kenny & Hart, 1992), clinical level of undereating can form. The impact of the nurturing environment (e.g., disconnectedness and criticism) in the formation of severe undereating is well documented in academic literature, showing that the causes of undereating run much deeper than body dissatisfaction. Despite the desire to be unhealthily thin is borrowed from socially constructed body image. Behind that, eating disorders likely represent a way of coping with identity issues and gaining control over one’s life (Polivy & Herman, 2002).

Undereating disorders come with severe biological consequence as the body is denied the essential nutrients it needs to operate properly. These disorders are extremely dangerous to physical health with the leading category being anorexia nervosa, providing the highest mortality rate of any distress classified as psychiatric disorder (Arcelus et al, 2011). Severe effects and notable mortality rates are also present in bulimia (characterised by normal-looking body weight but ill metabolism due to the cycles of binge eating and purging – vomiting, laxatives) and binge eating disorders (binge eating without purge cycles).

Amongst the general population, temporary decline of appetite and loss of weight can occur as a response to more severe or chronic stress while not necessary reaching clinical level of underweight. Most of us naturally know that a sudden weight loss likely derives from a crisis in one’s life. The reduced food intake is driven by physiological changes that interfere with digestion by delaying glucose absorption and gastrointestinal transit (Blair et al., 1991). This decreased capacity to digest and the lingering food in the stomach creates a feeling of faux fullness, resulting in loss of appetite.

How the environment shapes what we eat, when we eat and how much we eat

Our food choices are not based merely on nutritional value as they were in the early days of our evolution. In those days, nutritional value and safety were the most important factors, as the natural world of food was filled with toxic plants, animals carrying infections, and edible foods that were nutritionally incomplete. In these times, most of our food choices were based on tasting and learning, the process which held severe risk (Breslin, 2013).

Today, this learning happens via cultural transmission even though, we still preserve genetical guidelines. These guidelines include the reluctance to try new food without seeing others eating it, and some innate taste and textural biases, such as sweet tastes being associated with the energy from fruits, and as such, very desired. While bitter tastes are associated with toxins, and fatty textures are associated with good substance (Rozin, 2005). Our food choices today are strongly influenced by both external and internal processes with the two major forces being social norms and social comparison.

The impact of social norms

Social norms are unwritten codes of conduct that provide a guide to appropriate behaviour which we unconsciously adapt to (Bandura, 1977). There are norms around eating as well and our diet commonly follows the norms of the peer group we belong to (Ball et al., 2010). Research repeatedly confirmed that we model the eating choices of our dining partners and consume similar amount and type of food to what they eat (Herman et al., 2003). Even though by default, we are motivated to eat as much food as we can, it is our social company that determines when we stop eating.

Research shows that amongst strangers or acquaintances we eat less to avoid the stigmatisation of overeating, while amongst friends we eat more to connect with them deeper and for longer. But when our friends eat less, we reduce our intake as well, and it’s enough to just hear about them eating less: we in turn decrease the size of our plate. This often referred to as impression management, as we attempt to control the picture other people form about us (usually linked to social goals e.g. fitting into our peer group; Vartanian et al., 2007). Conveying a good impression through eating at any age appears to involve eating less, because obesity is highly stigmatized in most Western cultures (Salvy et al., 2012).

The impact of social comparation

Social comparison on the other hand is the innate drive of every human to evaluate their own abilities by comparing themselves to others (Festinger, 1954). We do it constantly, in every aspect of life including eating. Depending on our state of mind, we either compare in an upward manner (to someone we think is better than us, e.g. in terms of body shape) which can evoke the feeling of inadequacy and shame. Or we compare downwards (to someone less fortunate in that area) which can lead to temporarily feeling better and eating more, resulting in guilt afterwards. The diet comparison is everywhere. Every time we see someone eating, we compare our plate to theirs (Cavazza, 2011). And just like social norms, social comparison also has the power to overwrite our satiation signals and take over the control on how much we eat.

As seen, there are strong social drives behind people engaging in different diets or striving to achieve certain body shape. We’re all affected by those drives; however, we’re not impacted by them in the same way. The frequency of exposure, the availability of social bonds that can buffer by reinforcing our personal qualities, our thought processes and environmental factors all contribute to the final result. Basically, the adage ‘we are what we eat’ is only true on the metabolic level, as the nutrients we consume serve as the building blocks for our cells (Harvard T.H. Chan School of Public Health, 2021), while everything else is driven by social codes.

The toxic dieting spiral

Contrary to the popular belief, diet is far from being a simple plan that can be done anytime with a little willpower. This is partially because willpower is a short term resource evolved to withstand acute stress, or exchange some current resources for a long term goal (Inzlicht & Friese, 2020), not to live with our bums tight for months and years on. Maintaining a healthy diet, and sustaining the result afterwards requires a strategy. Lack of understanding of how a planned behaviour like a diet works and how to routinize new habits are contributing factors for both overeating and undereating.

Dieting, which is at its core a restrained method of eating, refers to adhering to a persistent pattern of eating-related rules. The biggest risk of a this setup is that it heightens our sensitivity to stress (Lattimore & Caswell, 2004). Reason being the restrictions, as we’re in constant discomfort during diet and any additional inconvenience can easily make us lose control. It is known that in response to fear and negative mood states, we consume more food, but that also applies for positive emotions and increased mental load.

Overall, getting emotional or busy are both known to impair our control and break the diet by increasing food intake (Macht & Mueller, 2007). The resultant weight fluctuation cause more issues that being overweight itself, and a multi-billion dollar diet industry relays on the failure of their products (Ogden, 2011).

In Western cultures the focus of most diets is still mostly on reducing food intake, which often results in malnutrition, bringing physical and mental difficulties, such as poor resistance to illness, and vulnerability for stress. The sheer number of dietary models that promote self-starvation is staggering and contributes to the widespread phenomenon called the epidemic of weight loss attempts (Ogden, 2010). The number of weight loss attempts is increasing parallel with obesity, linking it to the failed attempts. Five or more failed attempts seemed to be particularly impactful on weight gain (Fabbricatore et al., 2013). The more disappointed one gets about the failed diets, the more addictive palatable foods become.

Putting together what has been discussed so far shows a vicious spiral of dieting and inadvertent overeating.

  • The media constantly promotes palatable food as a part of our culture. It’s socially expected to eat them as a guest and offer them as a host.
  • The high fat nature of these palatable foods makes the person less conscious about when they’re full and increases the daily food intake, leading to inadvertent calorie overtake.
  • The person starts noticing their weight gain via social comparison, increasing their general anxiety about their body. The fear of bullying and loss of social position induce further anxiety.
  • Gyms and weight loss programs promise a quick fix, and the person finds themselves in the middle of the ‘healthism’ and ‘fitnessism’ craze that moralising working out and propagate the idea that any body fat is a sign of weakness. The fear of judgement, now on the moral level, further increases the general anxiety which decreases the control over food intake.
  • The person tries out a diet, but are not aware of the complexity of the process e.g. upfront preparation, accounting for emotional resources, balancing performance, etc. Since they’re inexperienced in managing several months of restricted living, and the diet industry sells bogus advices, they likely set unrealistic diet goals and unsustainable diet methods.
  • The failed diet is likely accounted to the person’s own flaws by media messages. Because their willpower is depleted by that time, they likely gain back more than they managed to lose. They feel exhausted and likely physically weakened by the poor and random nutrition consumed. But they still want their old body back and try to avoid social shaming so they try another diet.
  • The repeated failure of dieting goals results in sinking into self-doubt and desperation which expose the person to the risk of emotional eating becoming their lifestyle.
  • After four/five attempts, the person gets desperately tired and start to think that this might be just how they are now.

The spiral described above is the story of millions of people, whose narrative is told in the mass media with the vast majority of the details being left out. Most of these spirals begin with a fairly common life crisis. Examples include divorce, exams, moving, the loss of a loved one, an so on. The vulnerability that led them to this spiral is usually temporary, but escaping it requires strategic efforts.

What makes a successful diet?

#1. Preparation

Being aware of what to expect is essential to deal with it, so it is highly recommended to start reading case studies and personal stories weeks before starting your diet. More importantly, try to find sources from trustworthy sites, like https://www.nhs.uk/better-health/lose-weight/, as weight loss is a billion dollar industry in which everyone, from local influencers to giant pharmaceutical companies, promote a biased and, in a lot of cases, unresearched or even harmful approach to weight loss. If you’re known to be vulnerable for emotional eating, it’s specifically important that you have support channels, which can be online communities where you can read others’ experiences and encouraging comments.

Diet as mentioned is a planned behaviour (Ajzen, 1985) with several stages involved.

  • The first stage is gaining knowledge about relevant diets, getting to know what they are about, trying to shortlist those that resonates with you and that can potentially fit into your current lifestyle. Not all will, and the less you need to stretch your lifestyle for the diet, the more resources remain to cope with the restrictions.

  • The second stage is forming an attitude towards the chosen diet via getting feedback from others who have tried it or have dietary expertise. That includes looking into what the wider social and scientific view on it. Do try to select your references from authoritative sources rather than commercial materials or influencers. It is worth consulting a trained nutritionist on how to approach the weight loss plan, especially if you’re an athlete with specific dietary needs as you need to maintain your performance.

  • The third stage is forming a perception on the control you have currently. Try to judge objectively whether you can commit to the diet now or there is too much else is going on and you’d better to rearrange a couple of things before starting.

  • The fourth stage is the intention stage, when the preparation happens (often called the “I’ll start the diet tomorrow”). If you are having a busy period in your life, you’ll likely stay longer in this stage. It is very important to have an objective view on your available resources, and set up a comfortable start date to ensure you have enough time to clear the path for the diet. In general, at least one week runway is usually necessary to have your mind ready for the incoming restrictions and to have your safety measures at place. These measures includes cupboard clean up, sweet replacement, contingency snack-substitutes, stress exercise plan etc. If you feel you need more time because more complex circumstances have to be dealt with, do set up a longer runway.

  • Finally, the fifth stage of a planned diet is the diet itself, when you put into practice all the things you prepared with upfront.

As seen from this extended list, the actual diet is only one of the five steps leading to weight loss. All the prior steps are necessary to achieve the weight goals. The other crucial component of success is choosing a suitable diet model during preparation.

#2. The diet model

Apart from the lack of preparation to accommodate the restriction, the other factor that contributes to the low achievement rates among dieters is the ineffective dieting model, including extreme behaviours such as vomiting, purging or using medication (Dean, 2000). Luckily, the common themes of self-set dieting goals amongst the general population are relatively healthy, including reducing sugar, fat, alcohol, carbohydrate intake, combined with modestly reducing the intake amount and increasing the exercise rate. (Kruger et al., 2004)

Based on the latest findings, the two methods that predict weight loss success, are ‘reducing calories’ and ‘increasing exercise’ (Knäuper, 2005). Research found, however, that in case of higher initial BMI, dieters who solely relied on caloric reduction were more successful than those using the combination of exercise and caloric reduction. Those who used calory reduction alone were getting almost twice as close to reaching their dieting goal than dieters who followed both rules. This is partially accounted for the lower levels of cardio-respiratory fitness in case of higher BMI dieters (McInnis, 2000), which may pose a barrier for exercise.

The other reason why the combined model only worked for lower initial BMI, is the known difficulty to lower weight that is close to normal (Knäuper, 2005). Meaning, lower BMI participants need to add more exercise to their plans to progress, as they cannot reduce the food intake further without jeopardising their daily performance.

Overall, these studies suggest that if the dieter’s initial weight is higher, caloric reduction alone is more effective, while in the case of close to normal weight, the combination of caloric reduction and physical exercise predicts weight loss success.

Low calorie diets

Low-calorie diets (1000 to 1500 kcal/day) can lower total body weight by an average of 8% in the short term and they considered as a safe strategy for weight loss. These diets are well-tolerated and are characterized as successful strategies in maintaining significant weight loss over several years.

In general, low-calorie diets are high in carbohydrates (55–60% of total daily energy intake) and low in fat (< 30% of energy intake) (Strychar, 2006). But reducing the energy content of the diet can be achieved by restricting protein, carbohydrate, or fat alone or in combination as well; at the same time one or more macronutrients can be increased (within an overall energy restriction) (Finer, 2001). Several approaches seem to offer greater efficacy: fat restriction, fixed energy deficits, or meal replacements.

The radicalised version of the low-calorie diet, the very low calorie diet (<800kcal/day) did not show greater long-term weight losses than regular low calorie diet in the research studies, and the long term regain of weight was greater. The side effects included gallstones, hair loss, constipation, muscle cramps and occasional death (Tsai & Wadden, 2006), and so is not recommended by any authority.

Note: Low-carbohydrate diets (low-carb lifestyle), known to be relatively high in fat and protein content, are also not recommended by the American Heart Association. These diets include the Protein Power diet and the Atkins diet (St. Jeor et al, 2001).

Summary

Food has great meaning in our life and is deeply engrained into our identity and social self-definition. Due to its personal and social symbols, eating is a field of active public debate with an immense amount of stigma attached to it. Eating is a topic that never goes old, while the diet industry around it keep producing bogus dietary programs, advisories and products. It requires great awareness of the external and internal forces shaping our eating habits to avoid getting lost in the spiral of weight gain and weight loss attempts. Always seek advice from reputable sources to guide your decisions, as what you eat has a fundamental impact on your mental and physical functioning.


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About the author

Ydus

MSc (Hons) Life sciences, PC Cognitive psychology, Brazilian Jiu-Jitsu